Monitoring changes in individual surgeon's workloads using anesthesia data

We investigated whether changes in the number of cases performed by surgeons can be used as an appropriate surrogate for anesthesia departments' billed units.

We used both number of cases performed and the American Society of Anesthesiologists' Relative Value Guide™ (ASA RVG) units to assess all operating room anesthetics of an anesthesia group for two sets of 13 four-week periods. The units correspond to Canadian basic units and time units.

Although the number of ASA RVG units is an economically important variable that quantifies perioperative workload, the number of cases is a suitable surrogate for ASA RVG units when used to monitor individual surgeons. The pooled mean Pearson correlation coefficient between the two variables was r = 0.95, with 95% confidence interval 0.94 to 0.96. In addition, there were essentially none to very weak pairwise correlations among surgeons.

Informal hospital analyses of relative changes in a surgeon's caseload over one year using anesthesia workload data or anesthesia billing data will generally give equivalent results. The principal importance of our findings is that they can be used by anesthesiologists, specifically department heads, in their role as part of operating room committees. Such committees institute plans to revise the caseload of one or a few surgeons, and they then evaluate the results of those plans. The findings of this study are applicable to all anesthesia groups and may be especially valuable to the heads of anesthesiology departments who do not have the data to repeat our analyses.